What to do when health problems or medical treatments thwart your love life

This is the time of year when stores are filled with red hearts and other reminders that Valentine’s Day is approaching. It’s a mood booster, not to mention a nice break from all that winter grey (at least up here in Boston). After all, what would life be like without romance, love—and sex?

Unfortunately, a variety of health problems—as well as some of the treatments for them—can get in the way of sexual desire and functioning. Here’s a quick look at some of the main sources of trouble and suggestions about what to try first. If these initial strategies don’t work, have a heart to heart with your doctor about what to do next. There may not be a quick fix for health-related sexual problems, but there are steps you can take to help ensure that you can still enjoy a love life while taking care of the rest of your health.

Arthritis

Arthritis comes in many guises, but most forms of this disease cause joints to become stiff and painful. The limitations on movement can interfere with sexual intimacy—especially in people with arthritis of the knees, hips, or spine.

One common solution is to try different positions to find a way to make sex physically more comfortable. Another option is to take a painkiller or a warm shower before sex to ease muscle pain and joint stiffness. Or try a waterbed—which will move with you.

You can read more online by viewing this helpful article posted by the American College of Rheumatology.

Cancer

Cancer treatment may have long-term impact on sexual desire and functioning. Surgery or radiation in the pelvic region, for example, can damage nerves, leading to loss of sensation and inability to have an orgasm in women and erectile dysfunction in men. Chemotherapy can lower sex drive in both men and women.

When you talk with your doctor about your cancer treatment, bring up any concerns about sexual functioning. There may be ways to modify your treatment to limit its effect on sexual function or to address problems that develop after treatment.

The American Cancer Society has an excellent article on the topic of sexuality after treatment that is worth reading.

Depression

About one-third to one-half of people with major depression (where mood impairs ability to function) experience sexual problems. Depression can be both the cause and the result of sexual problems. For example, depression may cause a loss of desire. Or sexual problems may develop first—perhaps as a consequence of some other health issue—leading to depression.

Someone who takes an antidepressant for depression may face a double whammy, because some of these drugs further impair sexuality. For example, selective serotonin reuptake inhibitors (SSRIs)—among the most commonly prescribed antidepressants—prevent or delay orgasm in 30% to 40% of people, and cause erection problems in 10% of men.

If depression is a cause of sexual problems, then treating the depression should alleviate them. But if sexual problems develop after you start taking an antidepressant, the problem is more likely to be the drug. A first step is to wait it out, because sometimes these sexual side effects diminish with time. If they persist, talk with your doctor about whether lowering the dose might help. It’s also possible that you can switch to a different antidepressant with fewer sexual side effects.

For more information, read an article on depression and sexuality from the Harvard Mental Health Letter.

Diabetes

One-third to one half of men with diabetes experience problems having or maintaining an erection—what doctors refer to as erectile dysfunction. The disease contributes to erection problems in at least two ways: by harming nerves and by damaging blood vessels in the penis. Women with diabetes also may develop nerve and blood vessel problems that affect sexual desire, arousal, and the ability to have an orgasm.

Carefully controlling blood sugar through a combination of diet, exercise, and medication (if necessary) is a first step to avoid nerve and blood vessel damage.

The American Diabetes Association also offers advice for men and for women about how to deal with sexual problems that may develop as a consequence of diabetes.

Heart disease

Cholesterol-clogged deposits inside coronary arteries are often at the root of heart disease. These deposits aren’t limited to the heart, but extend to arteries throughout the body. They are a leading cause of erection problems in men (one reason why heart disease and erectile dysfunction often occur together), and can also contribute to arousal difficulties in women.

High blood pressure creates other problems, by damaging the inner lining of arteries and impeding blood flow to the penis and the vagina. Making matters worse, some blood pressure medications can cause erection problems.

Engaging in regular physical activity—which helps lower blood pressure and improves blood flow throughout the body—may not only help improve your heart health but may also improve sexual functioning. (Think of it as one more motivation to get off the couch.) If a blood pressure medication is contributing to your sexual problems, switching to a different drug may help.

The American Heart Association has published brochures and other advice for people who want to remain sexually active following a heart attack or stroke.

And by all means discuss your concerns with your doctor the next time you go for a heart checkup. After all, one of the reasons for keeping your heart healthy is so you can share it with someone!

For more information

Much more information about how to maintain healthy sexual functioning as you age and face health problems is available through our Special Health Report, Sexuality in Midlife and Beyond.

Or you can contact any of the advocacy organizations listed below for additional information about how to cope with specific health problems:

The Arthritis Foundation

The American Cancer Society

The American Diabetes Association

The American Heart Association

The Depression and Bipolar Support Alliance

The National Alliance on Mental Illness